Purpose: To evaluate prospectively outcomes of dentoalveolar surgery and its impact on developing BRONJ in bisphosphonates treated patients. Materials and Methods:Fifty six patients were the candidates of this study. They were divided into study group (n= 28) that underwent surgery (teeth extraction), and control group (n= 28) that did not underwent any surgery. Evaluation of healing to detect the occurrence of BRONJ was done.Cases that developed BRONJ were managed according to AAOMS recommendations. Results:From the 28 cases, only 2 cases developed BRONJ (7.14%). Cone beam radiological imaging was performed for them to evaluate the extension of the lesion. One of them considered as stage II BRONJ was managed by debridement and sequestrectomy. A swap of pus was examined by a culture and sensitivity test. Eight weeks after surgery and providing appropriate antibiotic, healing and complete soft tissue coverage was obtained with resolution of BRONJ signs. The other case considered as stage III BRONJ (lesion involving the sinus floor) was managed by debridement and sequestrectomy. The soft tissue failed to cover the bone with persistence of BRONJ signs. Surgical resection of all infected bone was done. Three months later, healing with complete soft tissue coverage was obtained with resolution of BRONJ signs. Histopathological analysis proved the presence of BRONJ in the bone biopsies obtained from the lesions of both cases. Conclusions:The results of this study indicate that only 7.14% of surgically managed cases developed BRONJ, While 0% of non-surgical cases developed BRONJ. This difference is statistically not significant suggesting that surgery can be performed for Bps patient if it was necessary.